BACKGROUND: The current study was performed to assess the efficacy of surveillance imaging in patients with head and neck cancer (HNC) who are treated definitively with radiotherapy. METHODS: Eligible patients included those with a demonstrable disease-free interval (≥1 follow-up imaging procedure without evidence of disease and a subsequent visit/imaging procedure) who underwent treatment of HNC from 2000 through 2010. RESULTS: A total of 1508 patients were included. The median overall survival was 99 months, with a median imaging follow-up period of 59 months. Of the 1508 patients, 190 patients (12.6%) experienced disease recurrence (107 patients had locoregional and 83 had distant disease recurrence). A total of 119 patients (62.6%) in the group with disease recurrence were symptomatic and/or had an adverse clinical finding associated with the recurrence. Approximately 80% of patients with locoregional disease recurrences presented with a clinical finding, whereas 60% of distant disease recurrences were detected by imaging in asymptomatic patients. Despite the earlier detection of disease recurrence via imaging, those patients in the group of patients with clinically detected disease recurrence were significantly more likely to undergo salvage therapy compared with those whose recurrence was detected on imaging (odds ratio, 0.35). There was no difference in overall survival noted between those patients with disease recurrences that were detected clinically or with imaging alone. Approximately 70% of disease recurrences occurred within the first 2 years. In those patients who developed disease recurrence after 2 years, the median time to recurrence was 51 months. After 2 years, the average number of imaging procedures per patient for the detection of a salvageable recurrence for the imaging-detected group was 1539. CONCLUSIONS: Surveillance imaging in asymptomatic patients with HNC who are treated definitively with radiotherapy without clinically suspicious findings beyond 2 years has a low yield and a high cost. Physicians ordering these studies must use judicious consideration and discretion.
BACKGROUND: The current study was performed to assess the efficacy of surveillance imaging in patients with head and neck cancer (HNC) who are treated definitively with radiotherapy. METHODS: Eligible patients included those with a demonstrable disease-free interval (≥1 follow-up imaging procedure without evidence of disease and a subsequent visit/imaging procedure) who underwent treatment of HNC from 2000 through 2010. RESULTS: A total of 1508 patients were included. The median overall survival was 99 months, with a median imaging follow-up period of 59 months. Of the 1508 patients, 190 patients (12.6%) experienced disease recurrence (107 patients had locoregional and 83 had distant disease recurrence). A total of 119 patients (62.6%) in the group with disease recurrence were symptomatic and/or had an adverse clinical finding associated with the recurrence. Approximately 80% of patients with locoregional disease recurrences presented with a clinical finding, whereas 60% of distant disease recurrences were detected by imaging in asymptomatic patients. Despite the earlier detection of disease recurrence via imaging, those patients in the group of patients with clinically detected disease recurrence were significantly more likely to undergo salvage therapy compared with those whose recurrence was detected on imaging (odds ratio, 0.35). There was no difference in overall survival noted between those patients with disease recurrences that were detected clinically or with imaging alone. Approximately 70% of disease recurrences occurred within the first 2 years. In those patients who developed disease recurrence after 2 years, the median time to recurrence was 51 months. After 2 years, the average number of imaging procedures per patient for the detection of a salvageable recurrence for the imaging-detected group was 1539. CONCLUSIONS: Surveillance imaging in asymptomatic patients with HNC who are treated definitively with radiotherapy without clinically suspicious findings beyond 2 years has a low yield and a high cost. Physicians ordering these studies must use judicious consideration and discretion.
Authors: Benjamin R Roman; Snehal G Patel; Marilene B Wang; Anna M Pou; F Christopher Holsinger; David Myssiorek; David Goldenberg; Samuel Swisher-McClure; Alexander Lin; Jatin P Shah; Judy A Shea Journal: J Natl Compr Canc Netw Date: 2015-01 Impact factor: 11.908
Authors: Ketan Shah; Luc Te Marvelde; Marnie Collins; Richard De Abreu Lourenco; Ieta D'Costa; Andrew Coleman; Tsien Fua; Chen Liu; Danny Rischin; Eddie Lau; June Corry Journal: Oral Oncol Date: 2015-03-06 Impact factor: 5.337
Authors: M McDermott; M Hughes; T Rath; J T Johnson; D E Heron; G J Kubicek; S W Kim; R L Ferris; U Duvvuri; J P Ohr; B F Branstetter Journal: AJNR Am J Neuroradiol Date: 2013-05-02 Impact factor: 3.825
Authors: David L Schwartz; Jerry Barker; Kari Chansky; Bevan Yueh; Leila Raminfar; Pamela Drago; Christine Cha; Mary Austin-Seymour; George E Laramore; Allen D Hillel; Ernest A Weymuller; Kent E Wallner Journal: Head Neck Date: 2003-12 Impact factor: 3.147
Authors: Neerav Goyal; Andrew Day; Joel Epstein; Joseph Goodman; Evan Graboyes; Scharukh Jalisi; Ana P Kiess; Jamie A Ku; Matthew C Miller; Aru Panwar; Vijay A Patel; Assuntina Sacco; Vlad Sandulache; Amy M Williams; Daniel Deschler; D Gregory Farwell; Cherie-Ann Nathan; Carole Fakhry; Nishant Agrawal Journal: Laryngoscope Investig Otolaryngol Date: 2021-11-30
Authors: Vivek Nair; Samuel Auger; Sara Kochanny; Frederick M Howard; Daniel Ginat; Olga Pasternak-Wise; Aditya Juloori; Matthew Koshy; Evgeny Izumchenko; Nishant Agrawal; Ari Rosenberg; Everett E Vokes; M Reza Skandari; Alexander T Pearson Journal: JAMA Netw Open Date: 2022-04-01